The present invention relates generally to a system and method for generating high-quality x-ray images using relatively small radiation doses. In particular, the present invention includes a system and method for generating x-ray images by utilizing time-of-flight information to derive contrast information. This time-of-flight information is derived by measuring the refractive index (i.e., ratio of x-ray velocity through matter as compared to velocity through a vacuum) of x-rays through a body, which can then be used to reconstruct an image of the body.
X-ray imaging is a common and powerful technique for non-invasive evaluation of a patient. Traditional x-ray images are generated by correlating the amount of attenuation experienced by x-rays passing through a subject to the type of material through which the x-ray passed. In particular, x-rays are stopped in tissues by way of energy transfers from the x-ray photons that occur roughly in proportion to the amount of material through which the x-ray passes. Consequently, the amount of attenuation experienced by an x-ray beam passing through a body forms a “signal” that is then used to generate an x-ray image. Hence, the “signal” used to generate an x-ray image is actually the lack or absence of energy or photons detected when an x-ray beam is passed through a patient.
The use of the lack of photons detected as the “signal” from which an image is generated presents a number of inherent problems. In particular, the number of photons illuminating a body varies randomly about a mean value. In this regard, more information can often be acquired using a higher dose of radiation (i.e. stronger x-ray beam) because a greater dynamic range of information is available. That is, it is desirable to have a very high number of photons (e.g., a million) “illuminating” a selected location in the body (e.g., 1 mm2) corresponding to each pixel in an image to ensure that there is a certain fractional reduction in the number of photons. Simply, image spatial and contrast resolution increase depends on the number of detected x-ray photons per image pixel.
However, high doses of radiation are typically undesirable due to the x-ray's potential to damage the body. In particular, there is a direct relationship between the number of x-ray photons interacting with tissue and the increased risk of radiation-induced tissue damage and cancer development. In traditional x-ray imaging systems that rely upon attenuation-based x-ray imaging, a dilemma is created between the need for increased contrast achieved using elevated radiation doses and the potential for damage that such doses can yield.
In an effort to overcome this problem, contrast agents are often introduced to better delineate certain anatomic features. However, these contrast agents also carry some risks.
Furthermore, enhancement of traditional x-ray imaging is limited to incremental reduction of radiation exposure. As a result, various systems and methods have been employed for increasing contrast resolution while minimizing x-ray dose. For example, one method modulates x-ray tube current (mA) as a function of beam angle with respect to the patient. Other systems have employed monochromatic radiation, rather than bremstrahlung radiation. Furthermore, some systems have attempted K-edge subtraction imaging and/or used photon counting (as opposed to traditional energy integrating) detector systems.
Unfortunately, these attempts for reducing radiation exposure in traditional x-ray imaging systems have been only somewhat successful. For example, modulating x-ray tube current as a function of beam angle relative to the patient, while first proposed in the mid 1980s, still has not been found to be compelling. Similarly, while monochromatic x-ray systems can reduce the effective dose at the chest by 18.7% and the dose to the head by 1.2%, at the same time, the dose delivered to the lumbar spine is increased by 38.3%, as is the dose delivered to intra-abdominal organs by 35-47%. Also, systems employing K-edge subtraction imaging and/or photon counting detectors have also been shown to decrease x-ray exposure needed to achieve a certain x-ray image quality. A major problem here is that tuneable monochromatic x-ray sources are still not routinely available for clinical use.
Recent developments, for example, in synchrotron x-ray-based imaging, have indicated that utilizing the differences in refractive index of x-rays (i.e., indicators of variations in the velocity of x-ray as they travel through different substances), rather than attenuation, as the imaging “signal” may greatly decrease the x-ray dose needed to reconstruct clinically useful images. As illustrated in FIG. 1, the refractive index of x-rays (ρ) with 12-24 kilo-electron volts (keV) 10, 12 serve as a much stronger “signal” than attenuation (μ) with 12 keV x-rays 14 or 24 keV x-rays 16. This is particularly true for elements having a low atomic number, which are more biologically relevant to clinical analysis.
While clearly being theoretically advantageous, velocity-based imaging systems have not been widely realized due to various formidable hurdles to actual implementation. In particular, while previously demonstrated as operable by imaging small specimens, systems have not been successfully developed that are appropriate for humans or full body imaging.
For example, one approach to make a system suitable for imaging humans is to “scale up” the refraction and phase contrast imaging methods developed for small-specimen imaging in an attempt to make them suitable for whole body imaging. These approaches are faced, however, with the problem of “unraveling” the many changes in refraction (expressed as phase shifts) that occur as the photon passes through 30 cm or more of tissue. For example, at 17.5 keV, 50 micrometers (μm) of water causes a 180 degree phase shift. Hence, for a 30 centimeter (cm) human abdomen, 6000 phase shifts would be expected, which is computationally cumbersome, if not currently impossible, to “unravel”.
A similar approach uses a Bonse Hart interferometer, which has been shown to successfully perform phase imaging of small specimens at relatively low keV. However, to implement this approach, a perfect silicon crystal is needed, which is difficult and costly to produce at the large scales necessary to image humans. Additionally, this method involves the use of Bragg diffraction to acquire a reference beam against which the beam transmitted through the object is compared. In this case, the optic path length of the reference beam should be stable to within 0.1 nanometer (nm), which presents another significant technological impediment to implementation. Therefore, phase-delay imaging, which utilizes the interference patterns resulting from coherent x-rays passing through different tissues, is suitable only for very small diameter specimens (e.g., 1 mm) and requires synchrotron radiation.
Other approaches involve the use of an x-ray Talbot interferometer or of an “analyzer” crystal that allows measurement of the angle of refraction of x-rays, which is used to generate an image with edge enhancement effects. In the former case, an object is imaged using coherent illumination passing through a phase grating. To perform the latter, a method commonly referred to as “Diffraction Enhanced Imaging” (DEI) is used to generate a transmission image with edge enhancement effect caused by the slight refraction of the x-rays in regions with rapid change of refractive index, such as occurs at the surface of collagen fibers and blood vessels.
However, each of these methods, as well as the others described above, rely on rather low energy x-ray photons (approximately 10-30 keV) having relatively long wave lengths because the low energy x-ray photons yield more obvious interference patterns and greater refraction deviation. The lower energy x-ray photons are not suitable for imaging larger human subjects because the majority of the photons are stopped by the long tissue path lengths. Thus, while these methods have been demonstrated as feasible on small specimens, they are not clinically viable for human patients.
Therefore, it would be desirable to provide a system and method for significantly reducing x-ray exposure while still producing an image of sufficient quality to be clinically useful. Moreover, it would be desirable to have a system and method for measuring variations in the transit times of x-ray photons as they traverse a relatively large body, such as a human body.